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General NPI Number Information
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NPI Number | 1194137075
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Entity Type | Organization
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Legal Business Name | POP'S PHARMACY
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Dates
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Enumeration Date | 05/27/2014
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Last Update Date | 05/27/2014
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Provider Practice Location Address
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Address Line | 11719 BEE CAVE RD #204
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City | BEE CAVE
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State | TX
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Zip | 78738-5539
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Country | US
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Telephone | 512-487-5650
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Fax |
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Provider Business Mailing Address
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Address Line | 11719 BEE CAVE RD #204
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City | BEE CAVE
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State | TX
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Zip | 78738-5539
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Country | US
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Telephone | 512-487-5650
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. JAMES WALLACE MONTGOMERY II
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Credential |
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Telephone | 512-487-5650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 29281
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License Number State | TX
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